June 8, 2008 by admin

2728. Reopening Final Determinations or Decisions Under the Rules of Administrative Finality

2728.1 When can we reopen a final determination or decision?

A final determination, revised determination, decision or revised decision may be reopened and revised by a Social Security office, an ALJ or the Appeals Council within certain time limits and under certain conditions. See §2016.

We may decide to reopen a final determination or decision on our own or as a result of receiving a written request from a claimant or beneficiary. A decision not to reopen a determination or decision is not an initial determination and is not subject to appeal.

2728.2 When can we reopen a determination or decision within 12 months?

We can reopen determinations or decisions within 12 months from the date of the notice of the initial determination for any reason.

2728.3 When can we reopen a determination or decision within 24 months?

We can reopen determinations or decisions within 24 months from the date of the notice of the initial determination if:

1. We receive new and material evidence;

2. We made a clerical error; or

3. The evidence that we used in making the determination or decision clearly shows that the determination or decision was incorrect.

2728.4 When can we reopen a determination or decision at any time?

We can reopen a determinations or decision at any time if:

1. It was obtained by fraud or an intentional act that results in fraud by the SVB claimant or beneficiary, or some other person; or

2. We made a clerical error that was unfavorable to you.

3. The evidence we used in making the determination or decision clearly shows that the determination or decision was incorrect and the result was unfavorable to you.

Last Revised: Apr. 18, 2006